Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 15;32(6):e293-e301.
doi: 10.5435/JAAOS-D-23-00332. Epub 2024 Jan 18.

Life Expectancy After Treatment of Metastatic Bone Disease: An International Trend Analysis

Davis L Rogers  1 , Micheal Raad, Julio A Rivera, Rikard Wedin, Minna Laitinen, Michala S Sørensen, Michael M Petersen, Thomas Hilton, Carol D Morris, Adam S Levin, Jonathan A Forsberg
Affiliations

Life Expectancy After Treatment of Metastatic Bone Disease: An International Trend Analysis

Davis L Rogers et al. J Am Acad Orthop Surg. .

Abstract

Introduction: The decision to treat metastatic bone disease (MBD) surgically depends in part on patient life expectancy. We are unaware of an international analysis of how life expectancy among these patients has changed over time. Therefore, we asked (1) how has the life expectancy for patients treated for MBD changed over time, and (2) which, if any, of the common primary cancer types are associated with longer survival after treatment of MBD?

Methods: We reviewed data collected from 2000 to 2022 in an international MBD database, as well as data used for survival model validation. We included 3,353 adults who underwent surgery and/or radiation. No patients were excluded. Patients were grouped by treatment date into period 1 (2000 to 2009), period 2 (2010 to 2019), and period 3 (2020 to 2022). Cumulative survival was portrayed using Kaplan-Meier curves; log-rank tests were used to determine significance at P < 0.05. Subgroup analyses by primary cancer diagnosis were performed.

Results: Median survival in period 2 was longer than in period 1 ( P < 0.001). Median survival (at which point 50% of patients survived) had not been reached for period 3. Median survival was longer in period 2 for all cancer types ( P < 0.001) except thyroid. Only lung cancer reached median survival in period 3, which was longer compared with periods 1 and 2 ( P < 0.001). Slow-growth, moderate-growth, and rapid-growth tumors all demonstrated longer median survival from period 1 to period 2; only rapid-growth tumors reached median survival for period 3, which was longer compared with periods 1 and 2 ( P < 0.001).

Discussion: Median duration of survival after treatment of MBD has increased, which was a consistent finding in nearly all cancer types. Longer survival is likely attributable to improvements in both medical and surgical treatments. As life expectancy for patients with MBD increases, surgical methods should be selected with this in mind.

Level of evidence: VI.

PubMed Disclaimer

References

    1. Wedin R: Surgical treatment for pathologic fracture. Acta Orthop Scand Suppl 2001;72:2p, 1-29.
    1. Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S: Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 1990;15:1110-1113.
    1. Forsberg JA, Eberhardt J, Boland PJ, Wedin R, Healey JH: Estimating survival in patients with operable skeletal metastases: An application of a Bayesian belief network. PLoS One 2011;6:e19956.
    1. Forsberg JA, Wedin R, Bauer HC, et al.: External validation of the Bayesian Estimated Tools for Survival (BETS) models in patients with surgically treated skeletal metastases. BMC Cancer 2012;12:493.
    1. Forsberg JA, Sjoberg D, Chen Q-R, Vickers A, Healey JH: Treating metastatic disease: Which survival model is best suited for the clinic? Clin Orthop Relat Res 2013;471:843-850.